Topoisomerase II inhibitor
- Stabilizes topoisomerase-II–DNA cleavage complexes → double-strand breaks
- Kills dividing tumor cells
- Secondary leukemia
- Myelosuppression
- Causes double-strand DNA breaks
- Anthracycline cardiotoxicity is cumulative and dose-limiting
Drugs with this mechanism (3)
- Dexrazoxane — Iron-chelating cardioprotectant for anthracyclines; a separate use rescues anthracycline extravasation.
- Doxorubicin — Anthracycline with cumulative, largely irreversible cardiotoxicity.
- Etoposide — Topoisomerase II inhibitor; central to curative testicular regimens.
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